PDF(Pubmed)
Abstract：
UNASSIGNED: Cardiogenic shock (CS) is the leading cause of death among patients with acute myocardial infarction (AMI) and is managed with temporary mechanical circulatory support (tMCS) in advanced cases. Patients with cancer are at high risk of AMI and CS. However, outcomes of patients with cancer and AMI-CS managed with tMCS have not been rigorously studied.
UNASSIGNED: Adult patients with AMI-CS managed with tMCS from 2006 to 2018 with and without cancer were identified using the National Inpatient Sample. Propensity score matching (PSM) was performed for variables associated with cancer. Primary outcome was in-hospital death, and secondary outcomes were major bleeding and thrombotic complications.
UNASSIGNED: After PSM, 1287 patients with cancer were matched with 12,870 patients without cancer. There was an increasing temporal trend for prevalence of cancer among patients admitted with AMI-CS managed with tMCS (P trend < .001). After PSM, there was no difference in in-hospital death (odds ratio [OR], 1.00; 95% CI, 0.88-1.13) or thrombotic complications (OR, 1.10; 95% CI, 0.91-1.34) between patients with and without cancer. Patients with cancer had a higher risk of major bleeding (OR, 1.29; 95% CI, 1.15-1.46).
UNASSIGNED: Among patients with AMI-CS managed with tMCS, cancer is becoming increasingly frequent and associated with increased risk of major bleeding, although there was no difference in in-hospital death. Further studies are needed to further characterize outcomes, and inclusion of patients with cancer in trials of tMCS is needed.
UNASSIGNED: Adult patients with AMI-CS managed with tMCS from 2006 to 2018 with and without cancer were identified using the National Inpatient Sample. Propensity score matching (PSM) was performed for variables associated with cancer. Primary outcome was in-hospital death, and secondary outcomes were major bleeding and thrombotic complications.
UNASSIGNED: After PSM, 1287 patients with cancer were matched with 12,870 patients without cancer. There was an increasing temporal trend for prevalence of cancer among patients admitted with AMI-CS managed with tMCS (P trend < .001). After PSM, there was no difference in in-hospital death (odds ratio [OR], 1.00; 95% CI, 0.88-1.13) or thrombotic complications (OR, 1.10; 95% CI, 0.91-1.34) between patients with and without cancer. Patients with cancer had a higher risk of major bleeding (OR, 1.29; 95% CI, 1.15-1.46).
UNASSIGNED: Among patients with AMI-CS managed with tMCS, cancer is becoming increasingly frequent and associated with increased risk of major bleeding, although there was no difference in in-hospital death. Further studies are needed to further characterize outcomes, and inclusion of patients with cancer in trials of tMCS is needed.
摘要：
■心源性休克（CS）是急性心肌梗死（AMI）患者死亡的主要原因，在晚期病例中采用临时机械循环支持（tMCS）治疗。癌症患者患AMI和CS的风险很高。然而,尚未对接受tMCS治疗的癌症和AMI-CS患者的结局进行严格研究.
■使用国家住院患者样本鉴定了2006年至2018年间接受tMCS治疗的AMI-CS成人患者，有无癌症。对与癌症相关的变量进行倾向评分匹配(PSM)。主要结果是住院死亡，次要结局是大出血和血栓性并发症.
■PSM后，1287例癌症患者与12870例无癌患者相匹配。在接受tMCS治疗的AMI-CS患者中，癌症患病率有增加的时间趋势（P趋势<.001）。PSM之后,住院死亡没有差异(比值比[OR]，1.00；95%CI，0.88-1.13）或血栓性并发症（OR，1.10；95%CI，0.91-1.34)在有和没有癌症的患者之间。癌症患者有较高的大出血风险（OR，1.29；95%CI，1.15-1.46）。
■在接受tMCS治疗的AMI-CS患者中，癌症变得越来越频繁，并且与大出血的风险增加有关，尽管住院死亡没有差异。需要进一步的研究来进一步表征结果，并且需要将癌症患者纳入tMCS试验。
■使用国家住院患者样本鉴定了2006年至2018年间接受tMCS治疗的AMI-CS成人患者，有无癌症。对与癌症相关的变量进行倾向评分匹配(PSM)。主要结果是住院死亡，次要结局是大出血和血栓性并发症.
■PSM后，1287例癌症患者与12870例无癌患者相匹配。在接受tMCS治疗的AMI-CS患者中，癌症患病率有增加的时间趋势（P趋势<.001）。PSM之后,住院死亡没有差异(比值比[OR]，1.00；95%CI，0.88-1.13）或血栓性并发症（OR，1.10；95%CI，0.91-1.34)在有和没有癌症的患者之间。癌症患者有较高的大出血风险（OR，1.29；95%CI，1.15-1.46）。
■在接受tMCS治疗的AMI-CS患者中，癌症变得越来越频繁，并且与大出血的风险增加有关，尽管住院死亡没有差异。需要进一步的研究来进一步表征结果，并且需要将癌症患者纳入tMCS试验。
